Years of Hunger in Cambodia: How it May Relate to Diabetes

PHNOM PENH, Cambodia – Cambodia is a country rich in resources, located just between Vietnam, Thailand and Laos. Plagued with years of conflict, Cambodia has become one of the highest-ranking countries in terms of its population going hungry.

Approximately a quarter of the 15 million people living in Cambodia are living on $1.25 per day, and almost 40% of children are not receiving proper nutrients in their diets.

Vitamin A, iodine and iron deficiencies are prominent among women lactating and pregnant.

Many Cambodians live in rural areas where they find employment as rice farmers and raising cattle. Technology has been a catalyst for poverty, though, as access to new technology and education is hard to come by in rural areas that are isolated from the densely populated areas. With slow production of rice, families face the predicament of living in poverty and hunger in Cambodia.

Supplies of rice only last for a couple of months, and with that small amount it is tough to spare any to sell.

Hunger in Cambodia works in a vicious cycle and poses a severe disadvantage for those struggling to stay afloat. With adults and children eating diets that exclude necessary nutrients, physical work, including farming, becomes harder and children who are in school have difficulty concentrating.

Although Cambodia is still one of the most impoverished countries in the world, food is growing increasingly easier to come by compared to past years. Some evidence suggests that the rise in food productivity in non-rural areas has contributed to a spike in the amount of Cambodians diagnosed with diabetes.

Lim Keuky, endocrinologist and head of the Cambodia Diabetes Association, believes that this sudden spike in diabetes is genetically tied to years of starvation and hunger in Cambodia. Mothers who are not ingesting proper nutrients while pregnant give birth to babies who do not develop properly in the womb, also known as the “thrifty phenotype.”

When fetuses, the babies had to adapt in a way that later puts them at risk of diabetes.

Rebecca Painter, a doctor at the Academic Medical Center in Amsterdam, explains that the lack of nutrients causes the fetal pancreas not to develop correctly, which in turn inhibits diabetes-preventing insulin to be produced.

Keuky wonders if the thrifty phenotype is at work in Cambodia–the rise in diabetes correlates with the rise in food availability. With more food more readily available, he believes it is possible that the pancreas has not developed to “support the food [now available]every day.”

Unfortunately, many Cambodians have been disregarding symptoms of diabetes early on. Fatigue, excessive hunger or thirst, hands and feet going numb are all early symptoms of diabetes that, if left untreated, can lead to organ failure, stroke or death.

Keuky, along with experts, state that other countries that have similarly experienced years of severe starvation and now a sudden increase in food availability should be wary of these symptoms.